HomeMy WebLinkAboutBuilding Permit Application ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED Jam(
Date: Permit Number: /Jw� (63
Building Permit Application
Planning and Development Services
Building and Code Regulation Division
2300 Virginia Avenue,Fort Pierce FL 34982
Phone: (772)462-1553 Fax: (772)462-1578 Commercial Residential X.
PERMIT APPLICATION FOR: Roof
PROPOSED IMPROVEMENT LOCATION
Address: 349-NE Bracken Rd. Port Saint Lucie, FL 34983
Legal Description: River Park-Unit 9-Part C BLK 82 Lot 5 (MAP 34/21S)
Property Tax ID#: 3419-570-0125-000-9 Lot No.5
Site Plan Name: Block No. 82
Project Name: Griffith,#8180990
Setbacks Front - Back: Right Side: Left Side:
DETAILED DESCRIPTION OF WORK „F
Re-roof 26 squares of asphalt shingles
CONSTRUCTION INFORMATION
apply:
GaPi 'ng Shutters rsHVAC Gas Tank . s Or .,
Windows/DoorsAdditional or to e e under this
check
Electric ❑ Plumbing Sprinklers Generator Roof
Total Sq. Ft of Construction: S . of First Floor:
Cost of Con struction:$ 11,208.00 UtilitiesInSewer Septic Building Height:
OWNER/LESS`EE: . `oNTRACTOR
Name WYnthea Griffith Name: Quinn Roberts,
Address:349 NE Bracken Rd. Company: The Home Depot At Home Services
City: Port Saint Lucie State:FL Address: 674 S Military Trail
Zip Code: 34983 Fax: City: Deerfield Beach State:FL
Phone No.(772)672-0237 Zip Code: 33442 Fax:
E-Mail: Phone No. (954)379- 1500
Fill in fee simple Title Holder on next page(if different E-Mail:
from the Owner listed above) State or County License: CCC058327
If value of construction is$2500 or more,a RECORDED Notice of Commencement is required.
Q_
SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION.:
DESIGNER/ENGINEER: _Not Applicable MORTGAGE COMPANY: _Not Applicable
Name: Name:
.Address: Address:
City: State: City: State:
Zip: Phone: Zip: Phone:
FEE SIMPLE TITLE HOLDER: _Not Applicable BONDING COMPANY: Not Applicable
Name: Name:
Address: Address:
City: City:
Zip: Phone: Zip: Phone:
I certify that no work or installation has commenced prior to the issuance of a permit.
St. Lucie County makes no representation that is granting a permit will authorize the permit holder to build the subject structure
which is in conflict with any applicable Home Owners Association rules, bylaws or'and covenants that may restrict or prohibit such
structure.Please consult with your Home Owners Association and review your deed for any restrictions which may apply.
In consideration of the granting of this requested permit, I do hereby agree that I will,in all respects, perform the work
in accordance with the approved plans,the Florida Building Codes and St. Lucie County Amendments.
The following building permit applications are exempt from undergoing a full concurrency review:room additions,
accessory structures,swimming pools,fences,walls,signs,screen rooms and accessory uses to another non-residential use
WARNING TO OWNER:Your failure to Record a Notice of Commencement may result in your paying twice for
improvements to your property. A Notice of Commencement must be recorded and posted on the jobsite
before the first inspection. If you,intend to obtain financin , onsul with lender or an attorney before
commenc' or or recording our N ice of Commencetnent.
S 6 a (IV-F�'- .
Signature of Owne Agent/Lessee Signatur of Contract r
STATE OF FLO DA / STATE OF FLORT
COUNTY OF ( COUNTY OF �/Yt.�
The for oing instrument was acknowledged before me The for oing instrument was acknowledged before me
this '1 day of 20 15 by this day of 20 15 by
Quinn Roberts 1 Quinn Roberts
(Name of person acknowl dging) (Name of pe son a <nowledging
(Signature of N taryic-State ofFt6Yic15) (Sign atu e o otary Publi - tate of Florida)
Personally KnownOR Produced Identification Personally Known OR Produced Identification
on Produ
Type of Identificaticed Type of Identification Produced
Commission No. /���V�o� (SeaJ) Commission No. ���S(oR� (S64ER FLENKER
�y AMBER FLENKER NOTARY PUBLIC
NOTARY PUBLIC STATE
STATE Of FLORIDAComm#EE215692
Revised 07/15/2014 Comm#EE215692
,, �; '^F 1e►�' Expires 7/11/2016
� Expires 7/11/2016
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEATURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE ' .
COMPLETE
INITIALS